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1699003855 NPI number — RAISA MERCEDES BASSART MSM, RD / LD

NPI Number: 1699003855
Health Care Provider/Practitioner: RAISA MERCEDES BASSART MSM, RD / LD

Information about “1699003855” NPI (RAISA MERCEDES BASSART MSM, RD / LD) exists in 1699003855 in HTML format HTML  |  1699003855 in plain Text format TXT  |  1699003855 in PDF (Portable Document Format) PDF  |  1699003855 in an XML format XML  formats.

NPI Number : 1699003855 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699003855",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BASSART",
    "FirstName": "RAISA",
    "MiddleName": "MERCEDES",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MSM, RD / LD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8620 SW 196TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CUTLER BAY",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33157-8010",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-255-0960",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "19590 OLD CUTLER RD",
    "SecondLinePracticeLocationAddress": "JM PERDUE MEDICAL CENTER",
    "PracticeLocationAddressCityName": "CUTLER BAY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33157-8048",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-466-3500",
    "PracticeLocationAddressFaxNumber": "786-466-3889",
    "EnumerationDate": "11/30/2009",
    "LastUpdateDate": "11/30/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "133V00000X",
        "TaxonomyName": "Registered Dietitian",
        "LicenseNumber": "ND3822",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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